Prevalence of Workplace Violence among Nurses in a Hospital: A Descriptive Cross-Sectional Study at Nepalgunj Medical College Teaching Hospital

Review Article

Prevalence of Workplace Violence among Nurses in a Hospital: A Descriptive Cross-Sectional Study at Nepalgunj Medical College Teaching Hospital

  • Srijana Sapkota *

*Corresponding Author: Srijana Sapkota. InstructorNepalgunj Nursing Campus, TU, IOM.

Citation: Srijana Sapkota (2023). Prevalence of Workplace Violence among Nurses in a Hospital: A Descriptive Cross-Sectional Study at Nepalgunj Medical College Teaching Hospital, J Clinical Research and Reports, 13(3); DOI:10.31579/2690-1919/314

Copyright: © 2023, Srijana Sapkota. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 20 March 2023 | Accepted: 29 March 2023 | Published: 06 April 2023

Keywords: workplace; violence; sexual harassment; nurses; prevalence

Abstract

This research article presents a descriptive cross-sectional study titled "Workplace Violence among Nurses in a Hospital." The study was conducted at Nepalgunj Medical College Teaching Hospital in Banke as a partial fulfillment of the requirements for the Bachelor in Nursing Science Programme. The primary objectives of the study were to determine the prevalence of workplace violence among nurses in a hospital setting. A quantitative approach utilizing a non-probability purposive sampling technique with a sample size of 62 was used to collect data, and a semi-structured questionnaire was employed as the instrument for data collection. The collected data was analyzed using the statistical package for social sciences (SPSS) version 20, and the findings were analyzed with various descriptive statistics such as frequency and percentage. The results of the study indicated that half of the nurses (50%) reported experiencing some form of violence in their workplace. Verbal violence was found to be the most prevalent form of workplace violence, accounting for nearly half (43.5%) of the incidents, while physical violence was reported by only 9.7% of the nurses and sexual violence by 8.1%. These findings underscore the need for proactive measures to prevent and address workplace violence in healthcare settings, with a particular emphasis on preventing verbal abuse.

Introduction

Workplace violence is a significant worldwide concern in the health sector, particularly for healthcare workers who are at high risk of being victims. Violence in this context includes physical assault, verbal abuse, or threatening behavior that occurs in a workplace setting, resulting in adverse effects on the health and productivity of workers. Furthermore, the consequences of workplace violence in the health sector can significantly impact the effectiveness of health systems, particularly in developing countries (Kitaneh & Hamdan, 2012).

Violence is “Behavior involving physical force intended to hurt, damage, or kill someone or something” (Oxford English Dictionary, 2014). Any action, incident or behaviour that departs from reasonable conduct in which a person is assaulted, threatened, harmed, injured in the course of, or as a direct result of, his or her work is known as workplace violence (International Labour Organization ,2004 ).

Violence against nurses in the workplace is a global problem that has gained increased attention in recent years. Research indicates that approximately 25% of registered nurses report being physically assaulted by a patient or family member, while over 50% report exposure to verbal abuse or bullying (Al Qadi, 2021). A study found that the prevalence of workplace violence in healthcare was over 50%, with rates ranging from 36.0% to 92.0% among nurses in developed and developing countries (Alam, Mallick & Akter, 2019). Additionally, nearly 22% of nurses experienced frequent violence from patients and their relatives in European countries, and prevalence varied from 10% to 95% in many countries worldwide (Pandey, Bhandari & Dangal, 2017).

Need for study

 

Nurses, who bear primary responsibility for providing life-saving care to patients, are victimized at a significantly higher rate than other healthcare professionals. Workplace violence is estimated to cause 17.2% of nurses to leave their job annually (Al Qadi, 2021).

 

A descriptive cross-sectional study conducted in Pokhara, Kaski, Nepal aimed to assess the prevalence and factors associated with workplace violence among nurses. Results showed that the majority of nurses (64.5%) reported experiencing some type of violence in their workplace. The prevalence of verbal violence, physical violence, and sexual violence were reported to be 61.5%, 15.5%, and 9%, respectively (Pandey, Bhandari & Dangal, 2017).

 

A study was conducted at a cardiac hospital in Kathmandu to assess the prevalence of violence among nursing staff. The results indicated that 68% of all respondents reported having experienced any type of violence at any point in time, with 47% reporting having experienced it in the last 12 months. Additionally, married nurses were found to be more likely to experience violence compared to single nurses (Dhamala, Bhattarai & Sharma, 2021).

 

In order to gain a better understanding of the scope and nature of workplace violence in Nepal, it is essential to gather information from various institutions and geographical locations regarding the extent of workplace violence, the severity, and related details (Dhamala, Bhattarai & Sharma, 2021).

 

There is a growing body of evidence indicating that healthcare workers, particularly nursing staff, face a significant risk of exposure to violent behaviors in the workplace. This hazard is now recognized as a major occupational risk worldwide. While violence in healthcare settings has long been acknowledged as a serious problem in many industrialized nations, recent research suggests that it is a global phenomenon (Rajbhandari & Kafle, 2015).

In light of this issue, it is imperative for educators to assess the prevalence of workplace violence among nurses and identify associated factors. This information can be used to increase awareness among nurses about the risks of violence, enabling them to take necessary precautions and encourage hospitals to address this important issue (Rajbhandari & Kafle, 2015).

Objective of the study

  • To assess workplace violence among nurses in a Hospital. 
  • To find out the prevalence of workplace violence among nurses.

Significance of the study

The incidence of workplace violence among nurses appears to be on the rise. Conducting a study to determine the prevalence of workplace violence among nurses in a hospital setting could prove to be beneficial.

The findings of such a study could be utilized as a valuable resource by aspiring student researchers.

Research question

 

What is the prevalence of workplace violence among nurses in a hospital?

 

Review of Literature

 

Nurses, who have the primary responsibility of providing life-saving care to patients, are victimized at a significantly higher rate than other healthcare professionals. (Al- Qadi MM, 2021).

 

Lei, Dyamg, and Liua (2016) conducted a cross-sectional study on Chinese nurses working at tertiary and county-level hospitals from December 2014 to January 2016. The purpose of the study was to determine the prevalence of workplace violence against nurses and identify associated risk factors. The study revealed that the prevalence of workplace violence among Chinese nurses was 65.8%, with verbal violence, physical violence, and sexual harassment accounting for 64.9%, 11.8%, and 3.9%, respectively. Workplace violence occurred more frequently in emergency and pediatric departments. The study also found that age, department, years of experience, and direct contact with patients were common risk factors for workplace violence against nurses across different levels of hospitals.

 

In a Debark hospital located in Northern Ethiopia, a cross-sectional study was conducted from April 1 to April 30, 2015, which involved 386 nurses. Data was collected using a self-administered questionnaire developed by the International Labor Office/International Council of Nurses/World Health Organization and Public Services International. The study findings revealed an overall prevalence of workplace violence among the nurses at 26.7% (Tiruneh, B.T., Bifftu, B.B., Tumebo, A.A. et al, 2016 ).

 

A cross-sectional study was undertaken in Public health facilities located in Gamo Gofa zone, Ethiopia, from February to March 2018, among a sample of 348 nurses. The study findings indicated that 43.1% of the nurses had experienced workplace violence, with 13.5

In Bangladesh, a descriptive study design was adopted at public hospitals, selecting a sample of 120 nurses through simple random sampling, to assess the prevalence rate of workplace violence. The study discovered that the prevalence of workplace violence was 64.2%. Additionally, the study identified a significant association between age, working experience, and marital status of nurses with workplace violence. (Alam, Latif , Mallick & Akter,2019).

As per previous research, several critical factors contribute to violence against nurses, including youth (higher prevalence among younger individuals), male gender, lower social or economic status, preexisting psychological disorders, treatment refusal, personality disorder, and previous hospitalization or psychological violence (Gates, Gillespie & Succop, 2011).

A descriptive cross-sectional study was conducted among 447 nurses working in various departments in three hospitals in Amman to determine the prevalence and sources of verbal and physical workplace abuse. The study revealed that the prevalence of verbal and physical abuse was 37.1% and 18.3%, respectively. Younger and less experienced nurses in emergency and intensive care departments experienced higher levels of abuse, and the usual perpetrators were patients and their relatives. (Ahmed, 2012).

A quantitative study was conducted among the nursing staff in the emergency unit of a teaching hospital in southern Brazil, where 88.9% of the participants reported experiencing workplace violence. Of these, 38% suffered from verbal abuse, 25.4% experienced mobbing, 11% reported physical violence, 9.1% suffered sexual harassment, and 5.4% reported racial discrimination (Luzia & Eiko, 2021).

A descriptive cross-sectional study was conducted among emergency nurses at one of the largest tertiary hospitals in Kenya. The study employed a structured questionnaire adapted from the ‘Workplace Violence in the Health Sector' to assess the prevalence of workplace violence (WPV). The results showed that the overall lifetime prevalence of WPV was 81.7%, and the 1-year prevalence was 73.2%. The most common forms of WPV were verbal abuse, physical violence, and sexual harassment (Kibunja, Musembi, Kimani, & Gatimu, 2021).

An institution-based cross-sectional descriptive study was conducted among 200 nurses in Pokhara, Kaski, Nepal, from July to December 2016. The study aimed to assess the prevalence and factors associated with workplace violence. The results indicated that 64.5% of the nurses reported experiencing some type of violence in their workplace. Among these, verbal violence had the highest prevalence (61.5%), followed by physical violence (15.5%) and sexual violence (9%). The nurses working in nongovernmental hospitals (75%) were more exposed to workplace violence than nurses at private and public hospitals (Pandey, Bhandari, & Dangal, 2017).

A cross-sectional survey was undertaken among the entire nursing staff of a tertiary hospital in urban Nepal, located in Kathmandu, to determine the prevalence of violence experienced by nursing personnel. The study revealed that a considerable proportion of respondents, 68% in total, reported experiencing some form of violence. Furthermore, 47% reported experiencing it within the last 12 months. Notably, married nurses were found to be at a higher risk of experiencing violence compared to their single counterparts ( Dhamala , Bhattarai & Sharma ,2021).

Review of related articles indicate that majority of nurses have experienced workplace violence at some point in their careers. Studies suggest that the prevalence of workplace violence among nurses ranges from 63% to 68%, with verbal abuse, physical violence, and sexual harassment being the most common forms of violence. The prevalence of verbal abuse is higher than that of physical violence. Perpetrators of physical violence were often found to be the relatives of patients. Workplace violence is frequently reported in emergency, maternity and gynecology departments, and ICU departments. Married nurses were found to be more vulnerable to workplace violence than their single counterparts.

Research Methodology

Research Design

The present investigation employed a quantitative research approach, specifically a descriptive cross-sectional design, to collect and analyze data regarding the phenomenon of workplace violence experienced by nurses within a hospital context.

Research Setting and Population

The study was conducted among the nursing staff working across all departments of Nepalgunj Medical College Teaching Hospital, situated within Nepalgunj Sub-Metropolitan ward no-12. This is a 250-bed super-specialty hospital with a total nursing staff count of 210.

Sampling 

Sample Technique

Non Probability Purposive Sampling technique was used.

Sample size

The sample size will be calculated as, n = z2x p(1-p)e2                           

 1+      z2 x p(1-p)

e2N

Where z signified 80% confidence level which is 1.282

Prevalence of the study (p)= 0.5 

Marginal error = ± 8% = 0.08

Population (N ) = 210

Adjusting the value the,   

0.08 x 0.08 x 210= 61.8

The sample size was62 

Inclusion Criteria

All registered nurses working in all departments of Nepalgunj Medical College Teaching Hospital who has worked ≥ 12 months.

Who were willing to participate in the study.

Who were available at the time of data collection. 

Exclusion Criteria 

Registered nurses working in all Departments of Nepalgunj Medical College Teaching Hospital who has worked ≤ 12 months.

Who were not willing to participate in the study.

Who were not available at the time of data collection. 

Instrumentation

The research instrument employed in this study was a semi-structured, self-administered questionnaire. It was designed in an English version and consisted of two main parts:

  • The first part of the questionnaire focused on gathering information regarding respondents' socio-demographic distribution and job-related characteristics. 
  • The second part was a semi-structured questionnaire aimed at assessing the prevalence of workplace violence experienced by nurses.

validity and Pretesting of Research Instrument

The content validity of the research instrument used in this study was established through a rigorous process involving extensive literature review, consultations with research advisors, subject matter experts, and a statistician, as well as the incorporation of valuable suggestions from peers.

To ensure the reliability and validity of the instrument, a pretesting process was conducted among 10% of the anticipated sample size, which included six respondents. The individuals involved in the pretesting process were excluded from the main study to prevent any potential biases or confounding factors.Top of FormBottom of Form

Ethical Consideration

Before data collection, administrative approval was obtained from concerned authority. The purpose of the study was explained to the respondents and verbal and written consent was obtained from all respondents.

The respondents were assured for the anonymity and confidentiality of the information given by them and respondents were allowed to withdraw from the participation at any time if they want. The collected data was kept confidentiality. 

Information was used only for study purpose.

Data collection Procedure

The research committee of Nepalgunj Nursing Campus granted the approval letter, which was subsequently submitted to Nepalgunj Medical College Teaching Hospital Nepalgunj. Prior to data collection, the purpose of the study was explained to the participants, and informed consent was obtained.

Data was collected through the use of self-administered semi-structured questionnaires. To protect the anonymity of the participants, a code number was assigned to each respondent. Confidentiality was ensured by informing participants that the data collected would only be used for research purposes. The researcher herself was responsible for collecting the data.

Data Analysis Procedure

The collected data underwent a thorough review process to ensure its completeness and accuracy. This involved checking, coding, and organizing the data appropriately. Measures were taken to ensure the safe storage of the data.

The Statistical Package for the Social Sciences (SPSS) version 20 was employed to analyze the data. Descriptive statistics such as frequency and percentage were used to interpret the analyzed data. The findings of the study were presented in tabular form to provide a clear representation of the results.

Findings of Study

This section pertains to the presentation of the study findings which were obtained from a total of 62 respondents. The participants were selected from all units of Nepalgunj Medical College Teaching Hospital during the data collection period of two weeks. The data collected was analyzed in accordance with the research objectives using descriptive statistics, namely frequency and percentage. The outcomes of the analysis are presented in various tables for ease of interpretation.


Table 1: Respondents’ Socio Demographic Distribution                                                                      n=62

Variables                                                 Frequency (n)                                     Percentage (%)

 

Age ( in year )

  Less than25

  26-30

  31-35

  36-40

 

Ethnicity

  Dalit

  Janajati

  Madhesi 

  Brahmin/Chettri 

 

Marital Status 

Married

Unmarried

 

Educational qualification 

  Pcl Nursing                                                             

  Bachelor in Nursing / Bsc. Nursing

 

 

 

16

                             36

                               9

                               1

 

 

                               3

 16

4

9

 

 

40

22

 

 

45

17

 

 

25.8

58.1

14.5

16.0

 

 

4.8

25.8

6.5

62.9

 

 

64.5

34.5

 

 

72.6

27.4

Table 1 presented that a majority of the respondents (58.1%) fell within the age bracket of 26-30 years, while the lowest proportion (16%) belonged to the age group of 36-40 years. With regards to ethnicity, the largest percentage of participants (62.9%) identified as Brahmin/Chettri, whereas the smallest proportion (4.8%) self-identified as dalit. In terms of marital status, over half (64.5%) of the respondents were married. Furthermore, the majority of participants (72.6%) held a PCL level nursing qualification.

Table 2: Respondents’ Job Related Information                                                                                   n=62

Variables                                                                                     Frequency(n)                                   Percentage (%)

 

Present post in working area 

  Staff nurse                                                           

  Senior staff nurse                                                                                                           

  Nursing incharge

 

Job Status 

  Permanent                                                             

  Temporary   

 

Year of working experience 

  ≥5   year                                                               

  6-10 year                                                     

<10>

 

Currently working area 

 

  Wards                                                                     

  Emergency /Gynae                                       

  Surgery/Uro / Labour

  Medical /A/C ward 

  Neuro/  Pediatric

  Orthopedic

 

  ICU                                                                         

  PICU / NICU /Surgical           

  Medical   

 

 Operation theatre                                                 

/Post operative ward           

 

 

 

51

6

5

 

 

14

48

 

 

32

24

6

 

 

 

32

 

 

 

 

 

 

20

 

 

 

10

 

 

82.3

9.7

8.1

 

 

22.6

77.4

 

 

51.6

38.7

9.7

 

 

 

47.1

 

 

 

 

 

 

29.4

 

 

 

14.7

Table 2 illustrates that the majority of respondents (82.3%) held the position of staff nurse, while the lowest percentages (8.1%) were nursing in-charge. Regarding job status, a majority (77.4%) of the participants held temporary positions. Similarly, over half (51.6%) of the respondents had working experience of five years or less. Nearly half (47.1%) of the participants worked in ward units.

Table  3: Prevalence of Physical Workplace Violence                                                                          n=62

Statement Frequency (n)Percentage (%)

 

Physically attacked in workplace within 12 months 

Yes

No

 

Physically abused by (n=6) *

Patient/client

Relatives of patient/client 

 

Sex *

  Male

  Female

 

Shift *

  Morning shift

  Evening shift

  Night shift

 

Respond to the physical violence *

Tried to defend myself

Reported it to a senior staff member 

 

Reported incident to *

  Senior staff member

  Ward incharge

 

 

 

 

56

 

 

3

4

 

 

2

4

 

 

3

2

4

 

 

5

4

 

 

3

4                                 

 

 

 

9.7

90.3

 

 

50.0

66.7

 

 

33.3

66.7

 

 

50.0

33.3

66.7

 

 

83.3

66.7

 

 

60.0

80.0

Note: Multi response *

Table 3 shows that the majority of respondents (90.3%) reported not having experienced physical abuse within the last 12 months. Among those who had experienced physical abuse, most (66.7%) identified the perpetrator as a relative of the patient/client, with a significant proportion (66.7%) of the perpetrators being female. The majority (66.7%) of physical violence incidents occurred during the night shift, with 50% of incidents occurring during the morning shift. A majority (83.3%) of the respondents responded to the physical violence. Furthermore, all respondents who experienced physical abuse reported the incident, with a majority (80.0%) reporting the incident to the ward in-charge. 

Table  4: Prevalence of Verbal Workplace Violence                                                                             n=62

 

Statement 

Frequency (n)Percentage (%)

 

Verbal abuse in workplace within 12 months 

Yes

No

 

Verbally abused by (n=27) *

Patient/client

Relatives of patient/client 

Staff member, colleague/worker

Ward  In charge

 

Sex *

  Male

  Female

 

Shift *

  Morning shift

  Evening shift

  Night shift

 

Respond to the verbal violence*

  Tried to defend myself verbally

  Reported it t to a senior staff member

 

Reported to *

 Senior staff member

  Ward incharge

  Head of the department                                                                                                                                               

 

 

 

27

35

 

 

11

19

4

11

 

 

26

12

 

 

13

15

18

 

 

23

11

 

 

18

12

3

 

 

 

43.5

56.5

 

 

40.7

70.4

14.8

                    41.1

 

 

96.3

44.4

 

 

48.1

55.6

66.7

 

 

85.2

40.7

 

 

66.7

44.4

11.1

 

Note: Multi response *

Table 4 displays that the majority (56.5%) of respondents did not report experiencing verbal abuse within the last 12 months. Among those who experienced verbal abuse, most (70.4%) identified the perpetrator as a relative of the patient/client, with a significant majority (96.3%) of the perpetrators being male. The majority (66.7%) of verbal abuse incidents occurred during the night shift, with over half (55.6%) of incidents occurring during the evening shift. The majority (85.2%) of respondents responded to the verbal violence. Moreover, all respondents who experienced verbal abuse reported the incident, with a majority (80.0%) reporting it to the ward in-charge.

Table  5Prevalence of Sexual Workplace Violence                                                                                n=62

Statement Frequency (n)Percentage (%)

 

Sexual abuse in workplace within 12 months 

Yes

No

 

Sexually abused by (n=5)*

Patient/client

Relatives of patient/client 

Staff member, colleague/worker

 

Sex *

  Male

 

Shift *

  Morning shift

  Evening shift

  Night shift

 

Respond to the sexual violence*

  Tried to defend myself                                                                   

  Reported it t to a senior staff member

 

Reported to *

  Senior staff member

  Ward incharge

 

 

 

 

5

57

 

 

1

2

3

 

 

5

 

 

1

2

3

 

 

2

3

 

 

2

3

 

 

 

8.1

91.9

 

 

20.0

40.0

60.0

 

 

100

 

 

20.0

40.0

60.0

 

 

40.0

60.0

 

 

50.0

75.0

Note: Multi response *

Table 5 demonstrates that the majority (91.9%) of respondents did not report experiencing sexual abuse within the last 12 months. Among those who experienced sexual abuse, over half (60%) identified the perpetrator as a staff member, colleague, or worker, and all perpetrators were male. More than half (60%) of the incidents of sexual violence occurred during the night shift, and a quarter (40%) occurred during the evening shift. Over half (60%) of the respondents responded to the sexual violence. All respondents who experienced sexual abuse reported the incident, with a majority (75%) reporting it to the ward in-charge.

Table 6: Prevalence of Workplace Violence                                                                                                          n=62

Workplace violence               Yes                                               No 

Frequency (n)     Percent (%)      Frequency (n)    Percent (%)

 

  Physical    violence  6                          9.7                              56                   90.3

 

  Verbal      violence27                        43.5                                35                   56.5

  Sexual       violence  5                          8.1  57                   91.9

 

Table 6 presents the prevalence of workplace violence among the respondents, indicating that half (50%) of them reported experiencing some type of violence in their workplace. Among the different types of violence, verbal violence had the highest prevalence, affecting nearly half (43.5%) of the respondents. Physical violence was the least prevalent, affecting only 9.7% of the respondents, while sexual violence was slightly more prevalent, affecting 8.1% of the respondents.

Discussion

A non-probability purposive sampling technique was employed to conduct a descriptive cross-sectional study among 62 nurses working in all wards of Nepalgunj Medical College Teaching Hospital, Nepalgunj, using a semi-structured self-administered questionnaire. The results indicate that 58.1% of the respondents were aged between 26-30 years. In comparison, a similar study conducted in Pokhara, Kaski, Nepal reported that more than half (59.4%) of the respondents were less than 25 years of age (Pandey, Bhandari & Dangal, 2017).

The results of the present study indicate that a majority (62.9%) of the respondents were from the Brahmin/Chettri community. This finding differs from a study conducted in Pokhara, Kaski, Nepal where the majority (51%) of the respondents were also from the Brahmin/Chettri community (Pandey, Bhandari & Dangal, 2017). Furthermore, in the current study, more than half (64.5%) of the respondents were married. This finding is dissimilar to a study conducted in Kathmandu, Nepal where the majority (61.4%) of respondents were single (Dhamala, Bhattarai & Sharma, 2021).

The present study reveals that the majority (72.6%) of the respondents were at the Proficiency Certificate Level. In contrast, a study conducted in China at tertiary and country level hospitals showed that above half (53.7%) of the respondents possessed a bachelor's degree (Lei, Dyamg & Liua, 2016).

Furthermore, the present study shows that above half (51.6%) of the respondents had working experience of less than or equal to five years. This finding is similar to the study conducted in public hospitals in Bangladesh (Alam, Mallick & Akter, 2019).

Moreover, the present study shows that the majorities were staff nurses, and the least were nursing incharge, which is consistent with the study conducted in public hospitals in Bangladesh.

The present study revealed that more than half (51.6%) of the respondents had a working experience of less than or equal to five years. This finding is consistent with the results of a study conducted in China on the prevalence of workplace violence. (Lei, Dyamg & Liua, 2016).

The present study found that almost half (45.1%) of the nurses reported experiencing some type of violence in their workplace. The prevalence of verbal violence was the highest (43.5%), followed by physical violence (9.7%) and sexual violence (8.1%). In contrast, a study conducted in China at tertiary and country level hospitals found a higher prevalence of workplace violence (65.8%), with verbal violence accounting for the majority (64.9%), while physical violence and sexual violence accounted for 11.8% and 3.9%, respectively. (Lei, Dyamg & Liua, 2016).

Similarly, a study conducted on workplace violence among nurses at public hospitals in Bangladesh found that the prevalence of workplace violence in healthcare was greater than 50%, with a range of 36.0% to 92.0% among nurses (Alam, Mallick & Akter, 2019). Another study conducted in Pokhara, Nepal, revealed that the proportion of verbal violence was higher (61.5%) compared to physical violence (15.5%) and sexual violence (9%) (Pandey, Bhandari & Dangal, 2017).

Conclusion

According to the results of this study, it was found that 45.1% of the participating nurses reported experiencing some form of violence in their workplace. Among the reported types of violence, the prevalence of verbal violence was found to be higher at 43.5% as compared to physical violence at 9.7% and sexual violence at 8.1%. These findings are consistent with a study conducted in China at tertiary and country level hospitals, which reported a prevalence of workplace violence in healthcare of 65.8%, with verbal violence being the most prevalent at 64.9%. Physical violence and sexual violence accounted for 11.8% and 3.9% respectively. Another study conducted in Public Hospitals in Bangladesh also found a prevalence of workplace violence in healthcare of more than 50%, with prevalence ranging from 36.0% to 92.0% among nurses. It is clear from these findings that violence in healthcare is a major issue that needs to be addressed.

Limitations

The present study was conducted at Nepalgunj Medical College using a non-probability purposive sampling technique, hence, the generalizability of the findings to other settings may be limited. Furthermore, due to time constraints and feasibility issues, a larger sample could not be included, and limited time of respondents posed difficulties for the researchers in the data collection process.

Implications

The findings of the present study can contribute to the existing body of knowledge and serve as a baseline for future researchers working on this topic. The study's results may also be beneficial to students and emerging researchers as a reference for their own research in this field.

Recommendations

It is recommended that further studies should be conducted to build upon the findings of the present study and address its limitations. One potential area of exploration could be a comparative study of workplace violence experienced by nurses in private hospitals versus those in government hospitals. This could potentially provide valuable insights into any differences in prevalence or types of violence experienced by nurses working in different healthcare settings. Additionally, it is suggested that future studies incorporate larger sample sizes and longer data collection periods to increase the generalizability of findings.

References

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

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Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

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Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

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Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

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Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

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Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

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Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

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Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

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Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

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Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

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Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

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Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

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Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

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Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

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Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

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Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

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Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

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Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

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Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

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Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

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Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

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Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

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Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

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Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

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Husain Taha Radhi

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S Munshi

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Tania Munoz

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George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

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Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

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Khurram Arshad

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Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

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Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

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Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

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Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

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Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

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Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

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Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

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Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

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Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

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Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

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Luiz Sellmann